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Inferring Outbreak Characteristics from a Short Observation Period of Symptomatic Patients

Description

The aerosol release of a pathogen during a bioterrorist incident may not always be caught on environmental sensors - it may be too small, may consist of a preparation that is coarse and heavy (and consequently precipitates quickly) or may simply have occurred in an uninstrumented location. In such a case, the first intimation of an event is the first definitive diagnosis of a patient. Being able to infer the size of the attack, its time, and the dose received has important ramifications for planning a response. Estimates drawn from such a short observation period will have limited accuracy, and hence establishing confidence levels (i.e., error bounds) on these estimates is an major concern. These estimates of outbreak characteristics can be also be used as initial conditions for epidemic models to predict the evolution of disease (along with error bounds in the predictions), in particular, communicable diseases in which the contagious period starts soon after infection (e.g., plague).

In this paper, we will consider anthrax and smallpox as our model pathogens. Since the contagious period of smallpox usually starts after the long incubation period (7–17 days), and the early epoch will consist only of index cases, we will model it as a non-contagious disease. Inputs will be obtained from simulated outbreaks as well as from the Sverdlovsk anthrax outbreak of 1979.

 

Objective

This paper presents a method that infers the number of infected people, the time of infection and the dose received from an aerosol release of a pathogen during a bioterrorism incident. Inputs into the inference process are the number of new diagnosed patients showing symptoms each day as observed over a short duration (3–4 days) during the early epoch of the outbreak.

Submitted by elamb on